Azithromycin – Convenient macrolide antibiotic with extended dosing intervals.
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What is Azithromycin?
Azithromycin is a highly convenient macrolide antibiotic that’s particularly valued for its short treatment courses and effectiveness against atypical bacteria. Its unique pharmacokinetics allow for once-daily dosing and shorter treatment duration compared to many other antibiotics.
Book an online consultation if you’re experiencing symptoms of respiratory infections, have been exposed to sexually transmitted infections, or have other bacterial infections that may benefit from macrolide antibiotic treatment. Our GPs can assess your symptoms and determine if Azithromycin is the appropriate antibiotic for your specific condition.
What is Azithromycin used for?
- Respiratory tract infections (chest infections)
- Chlamydia and other sexually transmitted infections
- Skin and soft tissue infections
- Atypical pneumonia
- Whooping cough (pertussis)
- Traveller's diarrhoea
- Mycobacterium avium complex (in HIV patients)
- Chronic obstructive pulmonary disease exacerbations
How does Azithromycin work?
A macrolide antibiotic that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit, particularly effective against atypical bacteria and some gram-positive organisms.
Dosage and Administration
Adults
500mg once daily for 3 days, or 500mg on day 1 then 250mg daily for 4 days. For STIs: single 1g dose.
Children
10mg per kg once daily for 3 days—GP will calculate appropriate dose based on weight.
Important Notes
- Can be taken with or without food.
- Complete the full course even if symptoms improve.
- For STI treatment: partners should also be treated.
- Long tissue half-life means shorter courses are effective.
Side Effects
Common Side Effects
- Nausea and vomiting
- Diarrhoea
- Abdominal pain
- Headache
- Dizziness
- Taste disturbances
Serious Side Effects
Seek immediate medical attention if you experience:
- Severe diarrhoea (C. difficile infection)
- Heart rhythm changes (QT prolongation)
- Liver problems
- Severe allergic reactions
- Hearing problems (rare, usually with high doses)
- Kidney problems
Important Warnings
- Tell your GP if you have heart rhythm problems or take medications affecting heart rhythm.
- May worsen myasthenia gravis—avoid if you have this condition.
- Tell your GP if you have liver or kidney problems.
- Can interact with many medications—inform GP of all medicines you take.
- May cause QT prolongation—ECG monitoring may be needed in at-risk patients.
Drug Interactions
Tell your GP if you're taking any of the following medications:
- Warfarin—may increase bleeding risk.
- Digoxin—may increase digoxin levels.
- Ergot alkaloids—may cause ergot toxicity.
- Ciclosporin—may increase ciclosporin levels.
- Antacids—may reduce absorption if taken together.
- Medications affecting heart rhythm—increased risk of arrhythmias.
Frequently Asked Questions
Why is Azithromycin usually prescribed for only 3-5 days?
Azithromycin has a very long half-life and accumulates in tissues, so shorter courses are as effective as longer courses of other antibiotics.
Can I take Azithromycin if I'm allergic to penicillin?
Yes, Azithromycin is a macrolide antibiotic, not a penicillin, so it's safe for people with penicillin allergies.
How effective is Azithromycin for chlamydia?
A single 1g dose of Azithromycin is highly effective for uncomplicated chlamydia, with cure rates over 95% when patients and partners are both treated.
Can I drink alcohol while taking Azithromycin?
There's no direct interaction with alcohol, but it's best to avoid drinking as it may worsen stomach upset and delay recovery from infection.
Medically Reviewed by: Mohammed Hassan - Independent Prescriber
Last Updated: 2025-01-14